JP4741772B2 - Endotracheal catheter and manifold assembly with seal and valve - Google Patents

Description

[0001]
(Technical field)
The present invention relates to a respiratory suction catheter assembly having an improved mechanism for flushing the tip of the catheter without drawing more air than necessary from a breathing circuit attached to the endotracheal catheter. More specifically, the present invention primarily relates to a closed suction endotracheal catheter system that minimizes or prevents air drawn from the patient's ventilation circuit, while Incorporating a wiper seal and valve arrangement that isolates the distal end of the catheter during cleaning provides improved cleaning of the catheter.
[0002]
(Background technology)
There are a variety of different situations in which a person needs an artificial airway such as an endotracheal tube that is inserted into a patient's respiratory system. In some situations, such as surgery, the function of the artificial airway is primarily to keep the patient's airway open so that sufficient pulmonary ventilation is maintained during the procedure. However, in many other situations, the endotracheal tube remains in the patient's body for an extended period of time. For example, in many patients, an endotracheal tube is left in the body to maintain mechanical ventilation and maintain the patient's life.
If the endotracheal tube is left in the body for a considerable length of time, it is important to periodically remove respiratory secretions. This is most often accomplished by using a respiratory suction catheter that is advanced into the endotracheal tube. As the suction catheter is withdrawn, negative pressure is applied to the inside of the catheter and mucus and other secretions are pumped from the patient's respiratory system. A significant amount of mucus and other secretions are collected through the catheter, but some of this mucus and other secretions remains outside the catheter.
[0003]
It is important to protect the clinician from contact with the catheter because the patient's secretions may contain pathogens such as Streptococcus, Pseudomonas, Staphylococcus and even HIV etc. . Similarly, it is important to protect patients from infectious pathogens present in the environment and pathogens carried by clinicians. This is particularly important in patients with mechanical ventilation, as the immune system is often impaired.
In addition to the concerns of cross-contamination, the patient's artificial airway suction can interfere with normal breathing. The most common group of patients with indwelling endotracheal tubes for long periods are those who must be mechanically ventilated. A mechanically ventilated patient typically has a fitting or manifold attached to the proximal end of the endotracheal tube (ie, the end that extends outside the patient) at the hub of the endotracheal tube. A pair of ventilator tubes extend from the mechanical ventilator and are typically attached to the manifold by an adapter. One tube supplies the patient with inhalation for inhalation. The other tube allows exhaled or exhaled air to flow out of the system.
[0004]
Until the 1980s, it was common to remove the manifold and ventilator tube from the patient whenever the patient needed suction. Preventing air supply to a patient, even for a few seconds, often caused unnecessary pain for the patient. This problem was first overcome in the invention disclosed in US Pat. No. 3,991,762. The '762 patent developed what is commonly referred to as a closed suction catheter system. In a closed suction catheter system, the catheter is maintained in a protective sleeve attached to the manifold. When suction is required, the catheter is advanced through the manifold and into the artificial airway. At this time, negative pressure is applied to the catheter, and secretions in the patient's respiratory system are pumped up.
The system has been improved by the invention disclosed in US Pat. No. 4,569,344. This system reduces the risk of cross-infection between the patient and the medical personnel using the device.
[0005]
In the past 15 years, there has been a significant transition to using a closed suction catheter system. The advantage of a closed suction catheter is that the closed suction catheter is opened during the suction procedure so that the ventilation circuit does not have to be removed from the patient during the suction procedure. Because catheters are used over and over again for 24 hours, it is important to remove mucus and other secretions from the catheter before not in use. If the secretions are not removed, there is an increased risk of self-contamination. It is also important to clean the catheter to maintain suction efficiency.
There are several mechanisms that can clean the catheter. U.S. Pat. No. 4,569,344 discloses an irrigation port that allows a user to inject fluid into the area surrounding the distal end of the catheter after the catheter has been withdrawn from the patient. When liquid is injected into the closed suction catheter device and suction is performed, the liquid helps to release and remove secretions from the outside of the catheter.
[0006]
Unfortunately, aspiration causes an undesirable amount of breathing air to be expelled through the catheter. In a “closed system”, the exhausted air can disturb a carefully controlled ventilation cycle. Thus, as a result of catheter cleaning, the amount of breathing air available to the patient may be reduced. If the clinician is unable to successfully remove the secretions from the catheter, multiple aspirations are made through the catheter, which repeatedly draws air from the ventilation circuit.
[0007]
Other closed suction catheters have been developed that have a cleaning or washing chamber that is physically isolated from the ventilation circuit. For example, US Pat. No. 5,487,381 discloses a closed suction catheter having an irrigation chamber shaped to receive the distal tip of the catheter as it is withdrawn from the manifold. The wall is then slid from the open position to the closed position, isolating the distal end of the catheter from the manifold and ventilation circuit. Usually, a port is provided for injecting the cleaning liquid into the cleaning chamber. Unfortunately, such a closed suction catheter may not be able to pass a sufficient air flow, which results in poor cleaning of the suction catheter. If there is not enough airflow to flow into the chamber, applying a negative pressure in the catheter creates an additional vacuum in the chamber. As a result, the isolated chamber prevents the cleaning liquid from being drained freely. The retention of the cleaning component further increases the risk that contaminated liquid will be reintroduced to the patient when the chamber is opened.
[0008]
In addition to the above concerns, clinicians using commercially available closed suction catheters are not able to clean the tip of the catheter sufficiently. If pathogens or other contaminants remain on the catheter for an extended period, the risk of contaminating the patient is increased. Furthermore, when the catheter dries with mucus and other secretions attached, the suction efficiency is hindered. In addition, it is often the case that the closed suction catheter device is quickly replaced by the unsightly appearance of the dried catheter with mucus attached. Therefore, there is a need for a catheter device that can more efficiently clean the distal end of the catheter without drawing a large amount of breathing air in the ventilation circuit.
[0009]
(Disclosure of the Invention)
The present invention relates to an improved respiratory suction catheter device including a manifold and a suction catheter for use in attachment to an endotracheal tube. In use, the manifold is attached to the artificial airway to form a ventilation circuit. The catheter can be moved through the manifold and into the patient's body to aspirate secretions from the lungs. At least one seal capable of wiping the distal tip of the catheter is disposed within the manifold. This seal allows the catheter to be cleaned as the catheter retracts from the patient and exits the manifold. This seal further cleans the catheter while minimizing the amount of air drawn from the ventilation circuit. As a result, removal of mucus and other secretions from the distal tip of the catheter is accomplished by the respiratory suction catheter system apparatus of the present invention.
[0010]
Embodiments of the improved respiratory aspiration catheter device typically include a manifold attached to an artificial airway such as an endotracheal tube to form a ventilation circuit, and aspiration from the artificial airway and lungs. A catheter movable through the manifold into the artificial airway and a wiper seal and valve configuration positioned adjacent to the ventilation circuit to minimize the air drawn from the patient's ventilation circuit while cleaning the catheter. Including.
[0011]
In a preferred embodiment, the valve is shaped to automatically contact the tip of the catheter after the catheter is withdrawn through the manifold, thereby allowing air to be drawn into the catheter during cleaning. Minimize the amount. In addition, the valve can be configured to lock in the closed position when pulled toward the catheter to be withdrawn, thereby ensuring that the catheter tip is isolated from the manifold.
The above and other objects, features and advantages of the present invention will become apparent upon consideration of the following detailed description taken in conjunction with the accompanying drawings.
[0012]
(Best Mode for Carrying Out the Invention)
Reference is now made to the drawings. In the drawings, various elements of the present invention are provided with reference numerals, and the same reference numerals are used for the same elements throughout. These reference numbers relate to various aspects of these preferred embodiments and are not intended to limit the scope of the invention disclosed and claimed herein. It will be apparent to those skilled in the art that aspects of the various embodiments described can be substituted and changed without departing from the spirit and scope of the invention. Moreover, the use of different reference numerals for corresponding elements in the subsequent drawings is merely for ease of understanding and is not intended to limit the scope of the invention.
[0013]
Referring to FIG. 1, a cross-sectional view of a prior art manifold 10 and catheter cleaning mechanism 14 is shown. The manifold has a valve mechanism in the form of a rotating rod 18 that can selectively isolate the cleaning chamber 20 from the ventilation circuit 26. When the distal end of the catheter 22 is placed in the cleaning chamber 20, cleaning fluid is injected from the side port 30 to help flush mucus and other secretions from the outside of the catheter 22. As used herein, “washing solution” or “saline solution” should be construed to include similar irrigation solutions or washing solutions recognized by those skilled in the art.
[0014]
However, because of the relative size and shape of the wash chamber 20, nothing forces a positive interaction between the saline solution and the secretions outside the catheter. Further, since the cleaning chamber is not shaped to receive makeup air when the rotating rod 18 is closed, the cleaning chamber 20 may become a vacuum and prevent effective suction. Another disadvantage of the embodiment shown in FIG. 1 is the closure mechanism that such a device must normally be operated manually. If the user fails to close the rotating rod 18, air is drawn from the ventilation circuit 26 by suction through the catheter.
[0015]
Turning now to FIG. 2, a cross-sectional view of another embodiment according to the prior art is shown. The manifold 100 is provided with a plurality of ports 104. The first port 104a is attached to the hub of the patient's endotracheal tube and directs breathing air to and from the endotracheal tube. This manifold thus forms part of the ventilation circuit. Air is typically supplied to and exhausted from the manifold through a second port 104b attached to a pair of ventilator tubes by a connector (not shown). The ventilator tube is connected to a mechanical ventilator (not shown) in a manner well known to those skilled in the art.
[0016]
The third port 104c is provided on the opposite side of the second port 104b. The third port 104c is normally covered with a cap 108 and is removed when a "blow-through" is desired to pull the patient away from forced ventilation, as will be described in detail later. The manifold also includes a fourth port 104d.
[0017]
Fitting 112 is shaped to form a press-fit engagement with fourth port 104d to effectively connect catheter 116 and optional protective sleeve 120 to manifold 100. Near the proximal end of the fitting 112, a flushing port 124 is provided through which flushing fluid can be injected to rinse the outside of the catheter 116. Such a shape is advantageous because the irrigation port 124 is located distal to the seal 128. The user typically pulls the catheter 116 until its distal end 116a is slightly distal from the seal 128 and then injects irrigation fluid into the irrigation port 124 to assist in the removal of secretions. Such a secretion removal method is generally effective, but may draw more air from the ventilation circuit 132 than is necessary to effectively clean the distal end 116a of the catheter 116. Further, it is common for respiratory therapists and other clinicians to continue aspiration through the catheter 116 while the catheter 116 is withdrawn from the first port 104a to a position adjacent to the seal 128.
[0018]
Turning now to FIG. 3A, a cross-sectional view of a portion of an improved endotracheal catheter, indicated generally at 200, is shown. The endotracheal catheter includes a manifold, indicated generally at 204, and a catheter 208. Manifold 204 includes a plurality of ports 212a through 212d. The first port 212a is shaped to attach to the proximal end of an artificial airway, such as a hub for an endotracheal tube. The second port 212b is typically connected to a pair of ventilator tubes (not shown) by an adapter (not shown) in a manner common in the art.
[0019]
As used herein, distal generally refers to the patient's direction, while proximal refers to the clinician's direction. Unless otherwise noted, each drawing is oriented with the distal (patient side) end facing upward in the drawing and the proximal (clinician side) end pointing downward in the drawing.
[0020]
During normal use, conditioned inspiration is pushed out of one of the ventilator tubes and enters the patient's lungs from the artificial airway through the second port 212b and the first port 212a. Exhaled air is carried through the first port 212a and then exits through the second port 212b to the other ventilator tube. Thus, the manifold 204 forms part of the ventilation circuit 214 through which breathing air circulates.
[0021]
In this embodiment, the third port 212 c also forms part of the manifold 204. The cap 216 normally covers the third port 212c. Whenever mechanical ventilation is used, the ultimate goal is that someday the patient will also be able to breathe spontaneously. To achieve this, the patient must always be separated from mechanical ventilation in order to breathe spontaneously.
To this end, the cap 216 can be removed from the third port 212c so that oxygen air passes through the patient's endotracheal tube but does not force inspiration into the patient's lungs due to a fully closed circuit. . This condition is commonly referred to as “blow-through” and allows the patient to gradually resume spontaneous spontaneous breathing.
[0022]
The manifold 204 includes a fourth port 212d as shown here. The fourth port 212d is positioned substantially opposite the first port 212a, and the catheter 208 slides into it to enter the first port to allow patient aspiration. When suction is complete, the catheter 208 is pulled back to the fourth port 212d so as not to obstruct the ventilation circuit 214.
A joint or adapter 220 is disposed between the wall forming the fourth port 212d and the catheter 208. At the outermost end, the adapter 220 is in contact with the wall forming the fourth port 212d. At the innermost end, the adapter 220 contacts a collar 224 that closely surrounds the catheter 208 such that a small cylindrical space 226 remains around the catheter 208. Ideally, the space between the catheter 208 and the collar 224 is between about 0.005 inches and about 0.015 inches.
[0023]
This proximity provides two important advantages. First, if it is required to supply saline for the patient's lungs, the catheter 208 is typically placed on the manifold 200 by injecting saline through the irrigation port 228 into the cylindrical space 226. After at least partial advancement therethrough, a saline flow occurs out of the distal end 224a of the collar 224 and through the first port 212a. If the space between the catheter 208 and the collar 224 is too large (as in the technique described above), the saline cannot be directed in this way. Second, as the catheter 208 is pulled back into the collar 224 after use, the collar helps to wipe away a thick layer of mucus and other secretions from the outside of the catheter.
[0024]
Infusing saline through the irrigation port 228 further removes secretions from the outside of the catheter 208 and improves ventilation by aspiration in the catheter. This shape also minimizes the amount of air and cleaning liquid required for effective cleaning.
Although the shape of the collar 224 shown in FIG. 3A is beneficial, the secretions normally deposited on the distal end 208a of the catheter 208 still remain. If such deposits are not removed immediately, the ability of the catheter to properly draw the patient will be affected. It may also become a pathogen medium within a closed suction catheter system. The present invention increases the uptime of the closed aspiration catheter system by reducing the amount of pathogen on the catheter 208 as disclosed herein.
[0025]
In accordance with one of the principles of the present invention, it has been found that selective cleaning of the air flow entering the distal end 208a of the catheter 208 significantly improves catheter cleaning. Furthermore, it has also been found that such a mechanism in an improved cleaning process minimizes the withdrawal of air from the ventilation circuit 214.
[0026]
As shown in FIG. 3A, the flap 232 is hingedly attached to an annular ring 236 located inside the fourth port 212d so that the flap 232 pivots relative to the ring to form a self-closing valve member. It has become. Of course, the flap 232 may be attached directly to the wall of the manifold 204 or the adapter 220 forming the fourth port 212d. A hinged attachment 240 allows the flap 232 to selectively move while maintaining alignment with the catheter tip, thereby forming a self-closing flap valve.
[0027]
As shown in FIG. 3B, the flap 232 is positioned to align with the distal end 208a of the catheter when the catheter 208 is withdrawn into the collar 224 almost completely. The hinged attachment 240 is sufficiently flexible so that suction through the distal end 208a of the catheter 208 pulls the flap 232 from near the first distal position to the second proximal position so that the flap The distal end 208a of the catheter 208 will be contacted. Thus, the flap 232 and associated structures form a natural closure valve and do not require additional external manipulation of the catheter system to close the valve.
[0028]
Like most closed suction catheters, the catheter 208 is formed with a primary hole 244 in the distal end 208a and one or more side holes in a position slightly proximal from the distal end 208a. 248 is formed. As the flap 232 moves proximally and contacts the distal end 208a of the catheter 208, suction through the catheter tip hole 244 is reduced or eliminated. Covering the hole 244 increases the suction flow in the lateral hole 248, thereby increasing the discharge of secretions that enter between the outside of the catheter 208 and the inside of the collar 224. Each side hole 248 is typically smaller than the distal hole 244, and the collar 224 restricts air flow into the side hole 248, thereby improving the cleaning of the catheter 208 while simultaneously drawing a small amount of air from the ventilation circuit. become.
[0029]
As shown in FIGS. 3A and 3B, the proximal side 232a of the flap 232 (ie, opposite the ventilation circuit 214) is substantially flat. In such a configuration, the proximal side 232a of the flap 232 can form a substantially complete seal with the distal end 208a of the catheter 208 to selectively close the catheter 208 from the manifold 200. .
[0030]
Turning now to FIG. 3C, an enlarged cross-sectional view of the embodiment shown in FIGS. 3A and 3B with a slight modification to the flap 232 is shown. Unlike the substantially flat flap 232 in FIGS. 3A and 3B, the flap 232 of FIG. 3C has a passageway 252 formed therein on the proximal side 232a. The passage 252 prevents the flap 232 from forming an airtight engagement with the distal end 208 a of the catheter 208. That is, the passageway 252 ensures that a measured volume of air is drawn into the hole 244 in the distal-most end 208 of the catheter.
[0031]
The measured volume of air drawn through the passage 252 has an important effect. Specifically, this air causes turbulence of air flow both within the catheter 208 and near the outer surface. Air turbulence helps break up mucus and secretion aggregates that are impossible with saline alone. Thus, turbulence in the air flow helps to provide an improved cleaning effect on the distal end 208a of the catheter 208. This is in stark contrast to many prior art devices that propose using a cleaning or washing chamber to clean the outside of the catheter. It is difficult to create turbulence in the chamber because the cleaning chamber or cleaning chamber is usually substantially larger than the catheter, or because makeup air is not specifically supplied. If there is no turbulence in the airflow, it is difficult to remove mucus and other secretions from the outside of the catheter.
[0032]
Turning now to FIG. 3D, yet another variation of the flap 232 shown in FIGS. 3A and 3B is shown. Rather than having a passage formed in the proximal side 232a, the flap 232 includes a hole 260 formed therein so that a relatively small amount of air can pass through the flap. The small holes cause air flow turbulence at the distal end 208a of the catheter 208, thereby increasing the cleaning effect. It is presently believed that the apertures 260 in the flap 232 are preferably about 0.03 inches in diameter.
[0033]
In FIGS. 3A-3D, the flap 232 forming the flap valve is shown as contacting the distal end 208a of the catheter 208, but need not contact the catheter itself. Thus, for example, FIG. 3E is shown in FIGS. 3A through 3D, except that the flap 232 is positioned to contact the distal end 224a of the collar 224 rather than the distal end 208a of the catheter 208. An embodiment similar to that is shown. In such a configuration, a suction flow through the hole 244 at the distal end 208a of the catheter 208 can still be obtained.
[0034]
A makeup air source is preferably provided, as will now be described in detail with respect to FIGS. 4A, 4B and 4C. This can be achieved using any of the flap shapes shown in FIGS. 3C and 3D. Alternatively, a small hole can be formed in the collar 224 to facilitate the entry of a small amount of makeup air and enhance the suction flow to increase turbulence.
Regardless of which of the shapes shown in FIGS. 3A through 3E is used, the distal end 208a of the catheter 208 is improved to be cleaned while at the same time significantly reducing the amount of air drawn from the ventilation circuit 214. Given ability. Thus, the patient is given stable ventilation and the clinician can more easily clean the catheter 208.
[0035]
Turning now to FIG. 4A, another embodiment of an improved endotracheal suction catheter device, generally designated 300, made in accordance with the principles of the present invention is shown. The improved endotracheal suction catheter device 300 includes a manifold 304 and a catheter 308. As in the previous embodiment, the manifold 304 includes a first port 312a, a second port 312b, a third port 312c, and a fourth port 312d.
This embodiment can further comprise a cap 316 on at least one port, which cap 316 is shown on the port 312c in this configuration. An adapter 320 can be disposed in the fourth port 312d. The adapter 320 may be attached to the manifold 304 by adhesion or simply a press fit.
[0036]
Unlike the embodiment described with respect to FIGS. 3A to 3D, the manifold 304 is not provided with an annular ring independent of the adapter 320. Rather, the annular ring 326 extends inwardly from the distal end 320a of the adapter 320. The annular ring 326 defines a hole or opening 330 through which the catheter 308 can extend. Accordingly, the opening 330 is slightly larger than the outside of the catheter 308.
A flap 336 also extends inward from the adapter 320. The flap 336 is preferably hinged to either the adapter directly or to the annular ring 326. When suction is not applied to the catheter 308 or when the distal end 308 of the catheter is disposed distally from the flap 336, the flap 336 extends generally distally from the annular ring 326 and substantially advances the catheter 308. Do not give resistance. As described herein, the flap 336 can benefit from an intake mechanism that biases the flap 336 to the closed position when the catheter 308 is retracted. Further, the flap 336 can be configured to be biased to this closed position.
[0037]
As shown in FIG. 4B, when the distal end 308a of the catheter 308 is withdrawn through the annular ring 326 with suction, a vacuum is created pulling the flap 336 over the opening 330, thereby distracting the catheter 308. The distal end 308a is isolated from the ventilation circuit 340 to prevent the catheter from drawing air from the patient to which the manifold is attached. When the flaps 336 are shaped as shown in FIGS. 3C and 3D, these shapes use make-up air from the ventilation circuit 340.
[0038]
If the catheter 308 simply remains in the chamber 348 behind the flap 336 or the annular ring 326 and saline is infused into the chamber, considerable negative pressure may be applied in the chamber. Further, since no relief is provided, it may be difficult to aspirate mucus and other secretions from the chamber when the cleaning liquid is drawn up and dried. To solve these problems in the prior art, the embodiment of FIGS. 4A through 4C is a makeup generally indicated at 350, formed on the wall forming the fourth port 312d of the manifold and a portion of the adapter 320. Provide an up air inlet. The makeup air inlet 350 preferably includes a filter 354 that is selected to substantially prevent contamination between the environment or the clinician and the patient. Adjacent to the filter material is a flexible barrier 358 that forms a one-way valve 360.
[0039]
As shown in FIGS. 4B and 4C, the one-way valve 358 is normally closed when the catheter 308 is in an extended position such that it extends through the opening 330 of the annular ring 326. However, when the distal end 308a of the catheter 308 is withdrawn through the opening 330 of the annular ring 326 and the flap 336 is pulled and closed, a vacuum will immediately develop on the opposite flap 336 side of the ventilation circuit 340. This vacuum opens the one-way valve 358 and supplies makeup air to the chamber. Make-up air flows through the flexible one-way valve member 358, causing air flow turbulence to help facilitate removal of respiratory secretions on the catheter 308. This is preferably accomplished at approximately the same time as the user infuses saline through the space 372 between the collar 374 and the catheter 308 utilizing the irrigation port 370. The one-way valve 358 is shaped so that it has very little resistance to the incoming air, or is substantially in the area before makeup air can flow into the proximal area of the flap 336. It will be clear that it is shaped so as to create a vacuum.
[0040]
Turning now to FIG. 5A, a partial cross-sectional view of another embodiment of an improved respiratory aspiration catheter device, indicated generally at 400, is shown. The endotracheal suction catheter device includes a manifold 404 and a catheter 408 movable through the manifold to aspirate secretions from the patient's lungs. As in the previously described embodiments, the manifold includes a first port 412a for attachment to an endotracheal tube or other artificial airway, a second port 412b for attachment to a ventilator tube of a mechanical ventilator, and a cap. An optional third port 412c covered by 416 and an optional fourth port 412d for receiving a connector or adapter 420 are included.
[0041]
A valve 424 having a shape generally called a duckbill valve is disposed at the distal end 420 a of the adapter 420. The valve 424 is formed of a piece of elastic material that opens when the catheter 408 is advanced therethrough and closes when the catheter is withdrawn. Valve 424 is attached to adapter 420 by a flexible base 428.
The adapter 420 is also provided with an air inlet 432 that is shaped to form a filter material 436 and a one-way valve 444 similar to that described in the previous embodiment. Member 440. Traditionally, duckbill valves have been used in endotracheal catheter systems, but the valve 424 shown in FIGS. 5A-5C is substantially advanced in several respects. First, as shown in FIGS. 5A and 5C, a spiral groove 450 is formed inside the valve 424. This helical groove 450 helps generate turbulent airflow around the distal end 408a of the catheter 408. In addition, the flexible base 428 is shaped to allow the valve 420 to be retracted in the direction of the collar 460, reducing the size of the wash chamber and improving the removal of secretions from the outside of the catheter 408. Can be made.
[0042]
With particular reference to FIG. 5B, a cross-sectional view similar to that shown in FIG. 5A but with the distal end 408a of the catheter 408 in the retracted position is shown. As the distal end 408a of the catheter 408 is withdrawn proximally from the valve 424, suction through the catheter acts against the flexible base 428 of the valve to retract the valve in the direction of the collar 460. . A base 428 of the valve 424 is provided with a pair of air inlets 470 to allow air to enter the valve.
[0043]
As shown in FIG. 5B, aspiration through the valve 424 and the air inlet 470 creates a vacuum between the adapter 420 and the flexible base 428, thereby opening the one-way valve 444 and the collar 460. Air can flow into the air inlet 470 at the upper end. This air is mixed with saline injected through the wash port 490 and moves along the distal end 408a of the catheter 408 with perturbation. The turbulent motion of the mixture of air and cleaning liquid is enhanced by the spiral groove 450.
When suction through the catheter 408 stops, there is no negative pressure from the catheter to keep the one-way flap valve 444 open or to keep the valve 424 adjacent to the distal end of the collar. Thus, the valve 424 can return to the state shown in FIG. 5A, except that the catheter 408 will remain substantially in the collar until the next use, and will be closed.
[0044]
Turning to FIG. 6A, an exploded partial cross-sectional view of a preferred embodiment of an improved endotracheal catheter made in accordance with the principles of the present invention is shown. As shown, this disassembled assembly comprises a positive end expiratory pressure (“PEEP”) or pressure seal 1286 or a similar resiliently closing membrane disposed within the adapter 1284 of the manifold. As shown, a pressure seal 1286 is placed in the cavity formed by the adapter 1284 of the manifold. The manifold adapter 1284 can then be inserted into a cavity formed in the seal retainer 1282. Seal retainer 1282 is also formed to enclose wiper seal 1280 or similar resiliently closing membrane when assembled. The wiper seal 1280 will be described in more detail later.
[0045]
Valve retainer 1288 then presses wiper seal 1280 into the cavity formed in seal retainer 1282. In this configuration, valve retainer 1288 preferably includes a wash port 1290. Wash port 1290 allows irrigation housing 1270 to be connected. In addition, the valve retainer 1288 also prevents the valve 1232 from being placed proximal to the previously described closed position. Note that valve 1232 further includes an optional hole 1260 to enhance cleaning as described herein.
[0046]
Next, FIG. 6B is a partial cross-sectional view of a preferred embodiment of the present invention, showing the assembled state of the preferred embodiment of the present invention. As shown, the housing 1200 includes three ports, ports 1212a, 1212b, and 1212d. Those skilled in the art will appreciate that more or fewer ports can be used to provide greater flexibility, such as providing a fourth port 1212c (not shown). Will. Further, as shown in the figure, the ports 1212a and 1212b can be formed to support swivel connection. As shown, ports 1212a and 1212b are formed at swivel connection positions 1204a and 1204b, respectively, so as to correspond to swivels 1274a and 1274b, respectively. In this configuration, the patient is given greater freedom of movement and less discomfort associated with coupling due to a non-fitting connection. In addition, the operation of the assembly by the clinician is easier for the patient.
[0047]
In addition, FIG. 6B shows a pressure seal 1286 securely installed in the manifold adapter 1284, as already shown in FIG. 6A. As shown, a portion of the outer surface of the catheter 1208 is in contact with the pressure seal 1286. In addition, a manifold adapter 1284 is shown disposed within the seal retainer 1282. Although these parts can be fused together, it is advantageous to removably connect these parts to accommodate greater flexibility and different shapes of the improved respiratory suction catheter device. It is.
[0048]
As shown in FIG. 6B, the distal end 1208a of the catheter 1208 approaches the wiper seal 1280. A hole 1244 formed in the distal end 1208a of the catheter 1208 provides a suction position. In addition, each with an additional hole 1248 can provide an additional suction position. As shown in this assembled shape, valve retainer 1288 presses wiper seal 1280 into place so that advancement of catheter 1208 does not move wiper seal 1280. Additionally, the valve retainer 1288 prevents the valve 1232, preferably the flap valve described herein, from moving from the closed position to the proximal position. In this configuration, the flap valve 1232 is connected to the collar 1210, but any other configuration disclosed herein is considered to be within the scope of the present invention as shown. The flap valve 1232 also has optional holes 1260 formed therein to enhance the cleaning effect as previously described. In addition, an irrigation port 1290 provides a mounting for the irrigation housing 1270. The irrigation housing 1270 can be press fit into the irrigation port 1290, or can be attached in other ways, providing an additional conduit for irrigation during the irrigation process.
[0049]
FIG. 6C is a partial cross-sectional view of the improved respiratory suction catheter device with the catheter 1208 translating through the manifold 1200, with the distal end 1208a of the catheter 1208 entering the patient's airway. It can be used. It is recalled that hole 1244 and optional hole 1248 can provide a suction position. Note that the flap valve 1232 is deflected to an open position so that the catheter 1208 can translate therethrough. In this configuration, the wiper seal 1280 can contact at least a portion of the outer surface of the catheter 1208 to assist in cleaning the catheter 1208 while retracting from the patient. As shown, when the catheter 1208 is retracted, the wiper seal 1280 can engage and remain in contact with a portion of the outer surface of the catheter 1208 during retraction. As the catheter 1208 is retracted, the wiper seal 1280 effectively scrapes mucus and other secretions from the outer surface of the catheter 1208.
[0050]
Further, the benefits of wiper seal 1280 are further enhanced by another embodiment of valve 1232. A valve 1232 comprising at least one protrusion 1292 extending beyond its flat surface, as shown in FIG. 6D, which is an exploded partial cross-sectional view of a preferred embodiment of a respiratory suction catheter device, is shown in FIG. 6G. As shown in more detail, the cleaning effect of the catheter 1208 can be enhanced.
[0051]
Specifically, as shown in FIG. 6E, which is a partial cross-sectional view of a preferred embodiment of a suction catheter device, when the catheter 1208 is advanced, its distal tip 1208 a is advanced to the wiper seal 1280. As shown in FIG. 6F, which is a partial cross-sectional view of a novel preferred embodiment of a respiratory suction catheter device, as the catheter 1208 passes through the wiper seal 1280, a portion of the outer surface of the catheter 1208 is wiped with the wiper seal 1280. Come into contact.
[0052]
In FIG. 6F, the catheter 1208 is advanced to come into contact with the proximal surface of the valve 1232. As previously described, contact with the valve 1232 reduces suction at the hole 1244, and if a hole 1248 is included, suction through the hole 1248 is increased to improve cleaning of the catheter 1208. The
At this time, the catheter 1208 is moving forward, but when the catheter 1208 is retracted, the state shown in FIG. 6F occurs again. As shown in FIG. 6F, aspiration at the distal end 1208a of the catheter 1208, typically through the hole 1244, can assist the flap valve 1232 such that the catheter 1208 contacts the flap valve 1232 to form a closed position. . In this embodiment, an optional hole 1260 is incorporated into the flap valve 1232 to enhance the cleaning effect after retraction.
[0053]
As shown, the wiper seal 1280 will scrape mucus and similar secretions from the outer surface of the catheter 1208 during retraction. If suction can be used to remove this mucus and secretions, the cleaning process is improved. This configuration reduces the chance that the catheter 1208 will move mucus or similar secretions over the distal surface of the valve 1232. In addition, an irrigation housing 1270 attached to the irrigation port 1290 of the valve retainer 1288 provides an opportunity to introduce irrigation fluid to help remove mucus and similar secretions from the outer surface of the catheter 1208.
[0054]
Referring to FIG. 6G, when at least one protrusion 1292 on the flap valve 1232, ie, a protrusion 1292 formed on the proximal surface of the flap 1232, is formed on the flap 1232, the flap is being advanced and retracted. Helps to separate 1232 from the catheter 1208. Specifically, the at least one protrusion 1292 formed on the proximal surface of the flap 1232 includes the outer surface of the catheter 1208 and the flap 1232 such that the protrusion 1292 contacts the catheter 1208 when the catheter 1208 is retracted. A first contact position can be provided between the two. In this configuration, the flat surface of the flap 1232 scrapes a small amount of mucus and similar secretions. This shape reduces the risk that the catheter 1208 will move mucus or similar secretions onto the distal surface of the valve 1232. Thus, more mucus and similar secretions enter the cleaning chamber formed by the valve 1232 and pressure seal 1286 in the closed position so that mucus and similar secretions are washed away during the cleaning process. Become. Importantly, the provision of the wiper seal 1280 allows most of the mucus and similar secretions to be removed during the retraction of the catheter 1208 through the manifold 1200.
[0055]
For this purpose, various shapes can be utilized in forming the wiper seal 1280. FIG. 6H is a cross-sectional view of an end face of some embodiments of wiper seal 1280, as shown in FIG. 6H, to form at least one wiper seal 1280, alone or in various forms and shapes. Can be used in combination.
Specifically, a wiper seal 1280a as shown in FIG. 6H has a circular surface 1281a, and a through hole 1287a is formed in this shape in a circular shape. The diameter of the through-hole 1287a is slightly smaller than the outer diameter of the catheter 1208 (not shown) so that the outer surface of the catheter (not shown) 1208 contacts most of the inner edge 1283a of the surface 1281a of the wiper seal 1280a. Or equal.
[0056]
As shown in the wiper seal 1280b, the surface 1281b of the wiper seal is formed such that a through hole 1287b is provided. In addition, at least one slit 1289b is formed in the surface 1281b to accommodate various catheter diameters that advance and retract through the passage hole 1287b. As previously described, when the catheter 1208 is advanced and retracted, it will contact the majority of the edge 1283b of the wiper seal surface 1281b.
[0057]
Referring now to the wiper seal 1280c, the wiper seal 1280c includes a surface 1281c forming a hole 1287c as described above. Furthermore, this embodiment shows a very plurality of slits 1289c formed in the surface 1281c of the wiper seal 1280c. In this configuration, the inner edge 1283c of the surface 1281c of the wiper seal 1280c remains very flexible and can accommodate large size changes in various catheter diameters that are advanced and retracted. As already described, the diameter of the through-hole 1287c is preferably less than or equal to the outer diameter of the catheter 1208 (not shown) that is advanced and retracted therein.
[0058]
Referring now to the wiper seal 1280d, the surface 1281d of the wiper seal 1280d includes an S-shaped slit 1289d formed therein. Advancement and retraction of the catheter 1208 (not shown) through the S-shaped slit 1289d expands the S-shaped slit 1289d to form a passage hole.
Similarly, the wiper seal 1208e includes a surface 1281e with a linear slit 1289e therein. Similarly, the catheter 1208 (not shown) opens the slit 1289e so that the catheter 1208 (not shown) can be advanced and retracted.
[0059]
Alternatively, the wiper seal 1280f includes a surface 1281f formed so that a hole 1287f is provided therethrough. The inner edge 1283f of the surface 1281f contacts and engages the catheter 1208 (not shown) as it passes through it. Note that the surface 1281f of the wiper seal 1280f further comprises at least one notch 1285f formed around the inner edge 1283f of the wiper seal 1280f. Each notch 1285f allows a slightly larger diameter catheter 1208 to accommodate the size of various catheters 1208 (not shown) so that it can be advanced and retracted therein.
[0060]
Further, the wiper seal 1280g includes a surface 1281g formed such that a hole 1287g is provided therethrough. The inner edge 1283g of the surface 1281g will be in contact engagement with the catheter as the catheter 1208 (not shown) passes through it. The surface 1281g of the wiper seal 1280g further includes at least one notch 1291g formed in the surface 1281g. As shown, the wiper seal 1280g includes a plurality of notches 1291g that form a vehicle wheel-like shape.
[0061]
Referring now to wiper seal 1280h, a shape similar to wiper seal 1280a is shown. Specifically, the wiper seal 1280h includes a surface 1281h in which a hole 1287h is provided. The wiper seal 1280h is formed such that the inner edge 1283h of the wiper seal 1280h can interact with the catheter 1208 as the catheter 1208 (not shown) is advanced and retracted therein. Note that wiper seal 1280h is shown in a cross-sectional view showing that sponge-like or similar rough material can be used for wiper seal 1280h.
[0062]
Alternatively, the wiper seal 1280i is formed such that a through hole 1287i is provided therein and an inner edge 1283i is formed in the wiper seal 1280i to contact the catheter 1208 (not shown) during advancement or retraction. Provided surface 1281i. This cross-sectional view shows that a brush-like or similar material can be used in forming the wiper seal 1280i.
[0063]
Referring to FIG. 7, an exploded partial cross-sectional view of another embodiment of an improved endotracheal catheter made in accordance with the principles of the present invention is shown. As shown, this disassembled assembly includes a pressure seal 1286 or a similar resiliently closing membrane disposed within the manifold adapter 1284. A pressure seal 1286 is placed in the cavity formed by the manifold adapter 1284. In this manner, the manifold adapter 1284 can then be inserted into a cavity formed in the seal retainer 1282. Seal retainer 1282 is also formed to enclose wiper seal 1280 or similar resiliently closing membrane when assembled.
[0064]
In this configuration, a cleaning port 1290 is disposed between the wiper seal 1280 and the pressure seal 1286 to form the cleaning chamber of this embodiment. Wash port 1290 allows connection to irrigation housing 1270. Note that this shape can eliminate the need for valves as shown in other embodiments for the assembly.
[0065]
8A and 8B, yet another endotracheal catheter embodying the principles of the present invention is shown. The respiratory suction catheter device 600 includes a manifold 604 and a catheter 608 movable through the manifold. As in many of the previously described embodiments, the manifold 604 has a first port 612a for connection to the hub of the endotracheal tube and a second port 612b for connection to the mechanical ventilator (via the ventilator tube). An optional third port 612c and a cap 616 that can be used for blow-through.
[0066]
The fourth port 612d differs from that already described because it has a shroud 620 positioned therein. The shroud 620 is attached to the plunger 624 and includes a first position where the user is adjacent to the sidewall of the fourth port 612d (FIG. 8A) and a second position where the shroud is located approximately in the center of the port 612d. The shroud can be moved between them.
[0067]
During use of the respiratory suction catheter device 600, the shroud 620 is normally moved to the first position so as not to obstruct the advancement of the catheter 608 through the manifold 604. When suction is complete, the catheter 608 is withdrawn into the collar 634.
The plunger 624 is then pushed and the shroud 620 is moved over the distal end 634a of the collar 634 to cover the distal end 608a of the catheter 608. Typically, at this time, the catheter 608 is advanced toward the distal end 620a of the shroud 620. A wash or wash is then added through wash port 640 while suction is applied.
[0068]
If necessary, a small gap can be formed between the shroud 620 and the collar 634 to ensure that turbulent airflow flows into the distal end 608a of the catheter 608. Similarly, grooves or some other pattern can be formed in the shroud to promote air flow turbulence. In addition, a valve member can be included to make the makeup air in the same manner as described for some embodiments above.
FIGS. 8A and 8B both illustrate an advantageous device 600 that includes a wiper seal 680. In this configuration, wiper seal 680 acts to scrape mucus and similar secretions from catheter 608 during retraction.
[0069]
Turning to FIG. 9A, an end view of the flap valve 932, the ring collectively designated 936, and the associated structure is shown. This flap valve 932 can be used in the illustrated embodiment. The flap valve 932 is attached to the ring 936 by two arms 948 that each form an attachment position 940. The opposite end 932c of the flap 932 engages a catch 964 or similar locking mechanism attached to the ring 936 by an arm 968. The catch 964 effectively locks the flap 932 in the proximal position until the user forcibly advances the catheter to the distal position until the catch releases the flap valve 932.
[0070]
It will be apparent to those skilled in the art that many modifications can be made to accomplish the principles of the invention. As an example, a single arm 948 can be used for the flap 932 and multiple catches 964 can be used. Similarly, instead of using ring 936a to support flap 932 and catch 964, a single ring can be used. Further, as shown in FIG. 9B, the flap 932d can be modified to provide other advantages. As shown in FIG. 9B, a pair of arms 948a attach the flap 932d to the ring 936a. As described above, the arm 948a can be shaped to bias the flap 932d to the closed position. The flap 932d further includes at least one protrusion 992a, shown here as a pair of protrusions 992a, which holds mucus and secretions until the catheter enters the wash chamber, as described herein. To help.
[0071]
The flap 932d is substantially circular but has two rounded protrusions 950a that extend outward and are approximately 90 degrees apart from each other. This protrusion serves two important purposes. First, the protrusion 950a prevents the flap from entering the endotracheal tube even if the substantially circular portion of the flap 932d is slightly smaller than the distal opening of the endotracheal tube (not shown). Second, the protrusion 950a aligns the flap so that the airflow continues to flow to the patient without covering the flap lying flat and preventing the passage of airflow to and from the patient. To do.
[0072]
Also shown in FIG. 9B is a hole 960a formed in the generally circular portion of the flap 932d. As shown, the hole 960a has a diameter between about 0.76 mm (0.03 inch) and about 1.02 mm (0.04 inch). Although illustrated as circular or disk-shaped, it will be apparent to those skilled in the art that other shapes of holes can be used in light of the present disclosure.
[0073]
FIG. 10A is a cross-sectional view of an embodiment of an endotracheal catheter system 1300 incorporating aspects of the invention. Endotracheal catheter system 1300 includes a manifold, generally designated 1304, that forms a fitting for connecting endotracheal catheter system 1300 to a patient's artificial airway (ie, endotracheal tube). The endotracheal catheter system 1300 also includes an elongated catheter 1308.
The manifold 1304 includes a first port 1312a, a second port 1312b, and a third port 1312c. The first port 1312a is shaped to engage an artificial airway such as an endotracheal tube. The second port 1312b provides breathing airflow to and from the patient. Usually, a Y-shaped adapter is attached to the second port 1312b. However, it will be apparent to those skilled in the art that many shapes are used in clinical settings and that different combinations are available.
[0074]
A third port 1312c is positioned opposite the first port 1312a, which allows the catheter 1308 to pass through the third port, through the manifold 1304, and through the first port into the artificial airway. Are aligned so that As shown in FIG. 10A, the first port 1312a and the second port 1312b have a swivel structure 1314 so that the manifold 1304 pivots with respect to the adjacent structure, thereby improving patient comfort. You can also.
[0075]
A joint or adapter 1320 is connected to the third port 1312c. On the outer surface of the distal end 1320a, the adapter 1320 contacts the wall forming the third port 1312c. The inner surface of the adapter 1320 forms a chamber around the distal end 1308a of the catheter 1308. This chamber helps to clean the distal end of the catheter in a manner that will be described in more detail later. A collar 1324 having a frustoconical bore 1328 extending therethrough is disposed adjacent to the distal end 1320a of the adapter 1320. It will be apparent to those skilled in the art that the collar 1324 can be integrally formed with the adapter 1320 if desired.
[0076]
When saline is injected from the wash port 1330 through the lateral opening 1332 and into the frustoconical bore 1328, the collar 1324 passes the saline along the catheter 1308 through the first port 1312a and into the artificial airway. Help to turn to.
The frustoconical bore distal end 1324 a forms an orifice at the distal end of the collar 1324. A flap 1340 supported on a support ring 1344 located at the third port 1312c selectively engages the orifice to substantially plug the orifice when the flap contacts the orifice. As in the previous embodiment, the flap 1340 preferably has one or more holes 1348 formed therein so that a small amount of air can pass through the flap valve. Also, as in the previous embodiment, the flap valve 1340 can be biased to the closed position or can be retracted to the closed position by suction through the catheter 1308.
[0077]
A wiper seal 1352 is disposed opposite the proximal end of the collar 1324. It is preferable that the narrowed portion 1320b of the adapter 1320 supports the wiper seal 1352. However, it will be apparent to those skilled in the art that other mechanisms can be used to hold the wiper seal 1352. As the catheter 1308 is withdrawn through the wiper seal 1352, the wiper seal removes most of the secretions.
[0078]
An adapter 1320 extends proximally from the wiper seal 1352 to form a cleaning chamber. A pressure seal 1356 is disposed adjacent the proximal end 1320c of the adapter 1320. Like the wiper seal 1352, the purpose of the pressure seal 1356 is to remove secretions from the outside of the catheter 1308 as it is withdrawn from the patient's artificial airway. However, pressure seal 1356 typically has a smaller diameter opening than wiper seal 1352 so as to more closely contact the outside of catheter 1308.
[0079]
Turning now to FIG. 10B, a cross-sectional side view of the endotracheal catheter assembly 1300 is shown with the catheter 1308 pulled through the manifold 1304 to the wash position. As the catheter 1308 is withdrawn, the flap 1340 closes, either by bias or suction through the catheter, and the opening of the collar 1324 closes.
As the catheter 1308 is withdrawn proximally from the collar 1324 and past the wiper seal 1352, the distal end 1308a of the catheter is wiped by the wiper seal 1352 and most of the secretions thereon are removed. The secretions removed by wiper seal 1352 are then conveyed through catheter 1308.
[0080]
As the distal end 1308a of the catheter 1308 advances beyond the first wiper seal 1352, a bottle 1360 is attached to the irrigation port 1330 and irrigation fluid (usually sterile saline) is supplied through the lateral opening 1332 of the collar 1324. The Lavage fluid flows around the distal end 1308a of the catheter 1308 as indicated by arrow 1364 and flushes away secretions that have not been removed from the distal end of the catheter with the wiper seal 1352. At the same time, the holes 1348 in the flap 1340 allow a small amount of air to flow through the catheter, thereby facilitating removal of secretions. If necessary, a make-up air valve that allows additional air to flow can be arranged on the side surface of the adapter 1320.
[0081]
In practice, seals and valves are polyurethane, ethylene vinyl acetate copolymer, polyvinyl chloride, polysilicon, polyamides such as nylon, polyethylene including high density, low density, medium density and linear low density types, Like ethylene α-olefin copolymers (such as ethylene-propylene copolymers), polyesters, polycarbonates, acrylonitrile-butadiene-styrene copolymers, polyether-polyester copolymers, and polyether-polyamide copolymers. It is desirable to be composed of a simple synthetic resin. Even more desirable are low pressure molded, relatively soft or flexible polymeric materials such as thermoplastic polymers including thermoplastic elastomers.
[0082]
For such internal parts, injection-molded medical grade synthetic resin materials are preferred. Suitable resins include Pebax® from Atochem North America, Philadelphia, PA. Most preferred are Pebax® 33 polyamide / polyether polymers, such as Pebax® 3533 SA00 polymer. Such polymers have an ASTM D2240 Shore D hardness of about 35, an ASTM D2240 Shore A hardness of about 85, an ASTM D790 flexural modulus of about 19995500 Pa (2,900 PSI), and an ASTM D1525 softening point. Is approximately 73 ° C. (165 ° F.) and has a melting point between about 109 ° C. (228 ° F.) and about 154 ° C. (309 ° F.).
[0083]
More preferably, ASTM D2240 has a Shore D hardness of approximately 55, ASTM D790 has a flexural modulus of approximately 165480000 Pa (24,000 PSI), and ASTM D1525 has a softening point of approximately 144 ° C. (291 degrees Fahrenheit). Characteristic Pebax® 5533 SA00 polyether block amide polymer with a melting point between about 128 ° C. (262 ° F.) to about 170 ° C. (338 ° F.).
[0084]
Polymers of thermoplastic elastomers that give excellent results as internal parts for use in the present invention include Monprene® from QST, including Monprene® MP-2870M, which has a Shore A hardness of ASTM D2240 of about 70. ) And a registered trademark name of Santoprene (registered trademark) of Advanced Elastomer Systems, including Santoprene (registered trademark) MP-2870M, which has a Shore D hardness of about 40 according to ASTM D2240. And the registered trade name Plowathane (registered trademark) of Dow Plastics, including Pellathane (registered trademark) 2363-80AE with a Shore A hardness of ASTM D2240 of about 85 Polyurethane (polyether) elastomers such as the ones described above, Elvax® 150 (33% vinyl acetate), Elvax® 360 (25% vinyl acetate) and Elvax® 450 (18% vinyl) Acetate) or Elvax® 750 (9% vinyl acetate). I. an ethylene vinyl acetate polymer marketed under the trade name Elvax® from Du Pont Packaging & Industrial Polymers, a low density polyethylene polymer such as 3447500 Pa (500 PSI), and Petrothene® NA270-000 low density polyethylene. Equistar Chemicals L. P. Low Density Polyethylene marketed by the company under the registered trademark Petrothene®, Unichem® 7811G-015 polyvinyl chloride polymer, Unichem® 8511G-015 soft polyvinyl chloride polymer and Unichem ( Polyvinyl chloride marketed under the trademark Unichem® by the Colorite Plastics Company, such as 6511G-015 soft polyvinyl chloride polymer, and Kraton® G-7705 styrene ethylene • Styrene ethylene sold under the registered trademark Kraton® by Shell Chemical Company, such as butylene styrene block copolymer. -Butylene-Styrene Block Copolymer and low density polyethylene commercially available under the registered trademark Tenite® from Eastman Chemical Company, such as Tenite® 1870A low density polyethylene polymer Polymer.
Furthermore, resins including thermoplastic polyurethane elastomers, thermoplastic elastomers, polyether block amides, silicones and / or rubbers provide each seal and / or valve with suitable elasticity for effective cleaning.
[0085]
The use of these various shapes can enhance the cleaning effect of the distal end of the catheter while minimizing air drawn from the patient's ventilation circuit or preventing air from being drawn. It will be apparent to those skilled in the art that modifications can be made without departing from the spirit and scope of the invention. The claims recited in the claims encompass such modifications.
[Brief description of the drawings]
FIG. 1 is a cross-sectional view of a manifold and catheter cleaning mechanism according to the prior art.
FIG. 2 is a cross-sectional view of a manifold and catheter cleaning mechanism according to another embodiment of the prior art.
FIG. 3A is a cross-sectional view of a manifold and distal portion of a catheter of an improved respiratory suction catheter device with a valve member in an open position in accordance with the principles of the present invention.
3B is a cross-sectional view of the manifold and catheter portion shown in FIG. 3A with a valve in a second closed position.
3C is a partially enlarged cross-sectional view of one embodiment of the improved respiratory suction catheter device shown in FIG. 3A.
3D is a partially enlarged cross-sectional view of another embodiment of the improved respiratory suction catheter device shown in FIG. 3A.
FIG. 3E is a cross-sectional view similar to that shown in FIGS. 3A-3D of another embodiment in which the seal is engaged with the collar.
4A is a partial cross-sectional view of another embodiment of an improved respiratory suction catheter device having a valve in an open position in accordance with the principles of the present invention. FIG.
4B is a partial cross-sectional view of the embodiment of FIG. 4A with the valve in a closed position and the catheter isolated from the ventilation circuit.
4C is a partial cross-sectional view of the embodiment of FIGS. 4A and 4B having an air make-up mechanism in an open position to facilitate the suction of mucus and other similar items. FIG.
5A is a partial cross-sectional view of another embodiment of an improved respiratory suction catheter device having a valve in an open position in accordance with the principles of the present invention. FIG.
5B is a partial cross-sectional view of the embodiment shown in FIG. 5A with the valve in a closed position.
FIG. 5C is a partial cross-sectional view of the valve of the embodiment shown in FIGS. 5A and 5B.
6A is an exploded partial cross-sectional view of a preferred embodiment of an improved respiratory suction catheter device with a seal that wipes contaminants from the distal end of the catheter. FIG.
6B is a partial cross-sectional view of an improved respiratory suction catheter device having a seal that wipes contaminants from the distal end of the catheter. FIG.
6C is a partial cross-sectional view of a preferred embodiment of an improved respiratory suction catheter device with a seal that wipes contaminants from the distal end of the catheter with the catheter advanced beyond the assembly. FIG. .
6D is an exploded partial cross-sectional view of an improved respiratory suction catheter device comprising a seal for wiping contaminants from the distal end of the catheter and another embodiment of a valve. FIG.
6E is a partial cross-sectional view of an improved respiratory suction catheter device comprising a seal for wiping contaminants from the distal end of the catheter and another embodiment of a valve. FIG.
FIG. 6F is a partial cross-sectional view of an improved respiratory suction catheter device comprising a seal that wipes contaminants from the distal end of the catheter and another embodiment of a valve.
6G is a preferred embodiment of an improved respiratory suction catheter device comprising a seal that wipes contaminants from the distal end of the catheter and another embodiment of a valve displaced by the catheter advanced through the device. FIG. FIG.
FIG. 6H is a cross-sectional view of several differently shaped end faces for the seal.
FIG. 7 is an exploded partial cross-sectional view of an improved respiratory suction catheter device with another configuration of a seal to form a wash chamber.
FIG. 8A is a partial cross-sectional view of yet another embodiment of an improved respiratory suction catheter device made in accordance with the principles of the present invention.
8B is a partial cross-sectional view of the improved endotracheal catheter of FIG. 8A when the valve mechanism is in the closed position.
9A is an enlarged end view of another embodiment of a valve. FIG.
FIG. 9B is an enlarged end view of another embodiment of a valve.
FIG. 10A is a partial cross-sectional view of another embodiment of an improved endotracheal catheter in which a pair of seals are used to improve cleaning of the distal end of the catheter tube.
10B is a cross-sectional view similar to that of FIG. 10A but with the catheter tube pulled back to the proximal position.

Claims (14)

A manifold having an internal passage from the proximal end to the distal end ;
An elongated catheter advanceable through the passageway ;
At least one resilient seal disposed within the manifold passageway , the distal surface of which has a sufficient cross-sectional area to wipe the catheter when the catheter is retracted from the manifold;
In the said manifold, is arranged on the side of the proximal end than the resilient seal has a sufficient cross-sectional area to maintain the pressure in the manifold in contact with the catheter, and at least one pressure seal,
A cleaning chamber formed between the elastic seal and the pressure seal;
A respiratory suction system , comprising: a cleaning port having an opening disposed in fluid communication with the cleaning chamber in the manifold passage and supplying cleaning fluid to the cleaning chamber .   The respiratory suction system of claim 1, further comprising a valve disposed distally of the resilient seal within the manifold to selectively occlude the catheter retracted from the manifold.   The respiratory suction system according to claim 2, wherein the valve is movable between an open position and a closed position.   4. A respiratory suction system according to claim 3, wherein the valve comprises a flap pivotable between the open position and the closed position.   The valve includes a collar, the collar having a bore extending therethrough and a flap shaped to selectively contact the collar and at least partially cover the bore. The respiratory suction system according to claim 2.   The respiratory suction system of claim 2, wherein the valve comprises a ring disposed within the manifold and a flap pivotally attached to the ring.   The respiratory suction system according to claim 2, further comprising a cleaning chamber formed by the valve and the pressure seal.   The respiratory suction system according to claim 1, wherein the elastic seal is a cylindrical disk. 9. The respiratory suction system of claim 8 , wherein the cylindrical disk has a hole formed therein. The respiratory suction system of claim 2 , wherein the valve comprises at least one protrusion extending from a flat surface on the proximal side thereof.   The respiratory suction system of claim 1, further comprising a flush port distal to the pressure seal.   The respiratory suction system according to claim 1, wherein the catheter is housed in a folding sheath.   The catheter has a distal end, and at least one resilient seal contacts the distal end of the catheter when the catheter is retracted from the manifold. The respiratory suction system according to claim 1. The respiratory suction system of claim 13 , wherein the at least one elastic seal is a wiper seal.

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